Category Archives: Minding the Media

USA Today on Thursday published an editorial hopefully entitled, Editorial: Fix broken mental health system. Which would be fine as a stand-alone piece advocating more money, focus and resources for our nation’s patchwork system of mental health and recovery care.

Instead, they — like many well-meaning but apparently brain-dead newspapers — tie the need to fix our mental health care system — something others have been advocating for for decades — to recent headline-news grabbing acts of atrocious violence.

Only buried in this hypocritical, two-faced gutter-piece editorial do you find the truth — “Only the tiniest fraction of the mentally ill ever become violent, and then, usually when they fail to get treatment.” It’s even worse than that — statistically speaking, mental illness is a horrible predictor of violence, and nobody who’s read the research would ever suggest otherwise.

I have no problem with you advocating to help people with mental health concerns. I have a big problem if you’re doing so because of violence in America. The two have little to no connection with one another.

People let to get all riled up and angry when something tragic occurs. It’s one way many of us cope and try to figure out such events. But when we respond to tragic events with action, we’re likely to do so in a way that makes little sense in the overall, broader picture.

The fact is people with mental health conditions are no more likely to be violent than is the general population.~ Wayne Lindstrom

For instance, every year in America, over 12,000 people a year are murdered — most by some sort of gun. Nobody gets upset at that huge number, or that 30,000+ people a year who take their own lives.

Instead, the thing that USA Today wants us to get motivated by are these horrific acts of violence that barely read in the overall number of deaths per year due to gun violence. USA Today doesn’t seem to care about the 30,000+ people each year who, because of untreated depression or other mental health concerns, choose to end their lives.1

Wayne Lindstrom, the CEO of Mental Health America, on the other hand, gets it right in his response to the crummy piece of what passes for “insightful opinion” at USA Today:

The premise that we can predict or prevent violent acts is unsupported. Even in the case of severe mental illnesses, mental health professionals possess no special knowledge or ability to predict future behavior.

The fact is people with mental health conditions are no more likely to be violent than is the general population. Continuing to link violence and mental illness only stigmatizes people and deters them from seeking care.

We whole-heartedly share and endorse these words. We stand proudly with Mental Health America and other organizations who’ve read the research and know that linking mental illness to violence is like linking terrorism to a specific religion — it’s a feel good strategy imbeciles do to make themselves feel better.

USA Today rues the good ole days, when we could lock up anyone society disagreed with or didn’t like the looks of in a mental hospital (nowadays referred to an inpatient psychiatric hospital): “Many states have become so strict that it is almost impossible to get people committed until they are in deep crisis, or try to commit suicide or harm someone.” Awww, what a shame — we actually have a reasonable, humane standard before trying to take someone’s freedom away from them.

USA Today should be ashamed of itself for publishing an editorial that only reinforces the discrimination, stigma and prejudice against people with mental health concerns. They continue to spread misinformation about the link between mental illness and violence,2 and suggest we have some sort of magical powers of foresight that would allow us to predict these kinds of incidents with such accuracy, it would be like the science-fiction story, “Minority Report” (we don’t have such magical powers, sorry).

Anyone can understand why school authorities would be jumpy, after the recent mass shooting at Newtown, CT.

But the recent suspension — and possible expulsion — of San Francisco high school student, Courtni Webb, is a fine example of how not to deal with suspected school violence.

Ms. Webb was suspended, according to news reports, for writing a poem about the Newtown killings, which apparently violated the school’s policy against threats of violence.

Poets, of course, have been deemed a threat to society ever since Plato banned them from his ideal “Republic.” Poetry, Plato argued, spoke to the heart, not the mind — and thus encouraged rebellion against the natural order of things.

But having heard Ms. Webb read her poem in its entirety, I found little in the way of violent rebellion, and certainly no overt threats to her classmates. Yes, the poem might be called self-absorbed — but isn’t that part of normal adolescence?

When Ms. Webb writes, “When you don’t feel loved/ you hate the world,” she could easily be expressing the feelings of thousands of alienated young people from time immemorial. Most of the poem seems to be an attempt to express her personal frustrations, and to understand the motivation of the Newtown shooter — not to threaten new violence.

We would be fortunate, as a society, if more lonely and alienated young people expressed their feelings in poetry, and fewer, through acts of violence.

We have yet to create a well-validated “profile” of those who carry out acts of so-called targeted violence, such as school shootings. The evidence to date suggests that perpetrators of such attacks tend to have very low self-esteem, a “persecutory/paranoid” outlook, depressive symptoms, narcissistic traits, and feelings of rejection. Perhaps one can find intimations of a few of these characteristics in Ms. Webb’s poem.

But as my colleague, Dr. James Knoll, has pointed out, focusing too heavily on these factors by “profiling” students would deluge school officials with “false positives.” Profiling alone — in the absence of careful, on-site assessment — casts far too broad a net to be useful.

Furthermore, as Prof. Eric Madfis of the University of Washington at Tacoma has pointed out, “zero tolerance” policies with mandatory arrests, suspensions and expulsions appear to do little to thwart targeted violence in schools.

Rather, schools do best by heeding the early warning signs of planned, targeted violence, such as when a would-be perpetrator “leaks” elements of the plan to another classmate, or posts threats on a website. Indeed, research from Finland found that adolescents aged 3-18 who expressed “massacre threats” online were a riskier group than adolescents who expressed the threats offline — for example, those who made online threats had often begun making actual preparations for the attack.

Of course, utilizing these early warning signs presupposes that knowledgeable peers or family members are willing to come forward to school authorities or police — and this happens all too rarely. As Prof. Madfis has noted, there is often a “code of silence” among adolescents that discourages coming forward with such information — which is widely regarded as “snitching.”

Nevertheless, the recent case of Blaec Lammers, in Bolivar, Missouri, shows that timely, personal intervention can make a huge difference. The young man’s plans for an Aurora-style movie theater massacre were thwarted when his mother reported him to local police.

Perhaps the most sensible recommendations for preventing targeted violence in schools come from the Interdisciplinary Group on Preventing School and Community Violence, writing in the aftermath of the Newtown, CT shootings. Among their conclusions was that the most effective way of preventing violence targeted at schools is by

“…maintaining close communication and trust with students and others in the community, so that threats will be reported and can be investigated by responsible authorities.”

The group did not endorse the use of “profiling” or checklists of personality traits. Rather, they urged the use of trained staff members who would investigate specific instances of apparent threats. Of course, schools strapped for funding will find it hard to implement such staff training — yet arguably, this may be more effective in preventing violence than posting armed guards at all our schools.

I also believe that greater cooperation between school health personnel and outside mental health specialists is sorely needed. For example, the school nurse or school psychologist could meet periodically with family physicians and psychiatrists in the community, to discuss students believed to be at high risk for targeted violence. This could be done via anonymous case presentations that would protect the privacy of potentially innocent students — and without simplistic “profiling.”

Some of these adolescents might be tugged off the path of violence through appropriate, voluntary counseling or mental health intervention. In cases of extreme or imminent threats of violence, involuntary treatment might be required, via appropriate judicial processes.

What will not help, in my judgment, is targeting students like Courtni Webb, who engage in acts of poetic expression, rather than savage violence.